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Study breakdown

Blunt use among Florida teens declined from 2010-2015 then reversed, rising sharply through 2020

Cross SectionalModerate evidence
The takeaway

Among 461,706 Florida middle and high school students surveyed from 2010-2020, blunt use declined through 2015 then reversed, with notable increases among girls, middle schoolers, and white students from 2015-2020.

School health officials, tobacco prevention program designers, youth substance use researchers

14.91% annual increase in current blunt use from 2015 to 2018

What the researchers found

Past and current blunt use declined from 2010 to 2015 (APC = -5.32% and -5.28%), but current use increased from 2015 to 2018 (APC = 14.91%) before leveling off. Rising trends were especially pronounced among female students (APC = 14.92%), middle schoolers (APC = 19.57%), and non-Hispanic white students (APC = 11.12%) from 2016 to 2020. Use of cigarettes, e-cigarettes, hookah, cigars, and vaping marijuana were all associated with blunt use.

Why it matters

Blunts combine tobacco (from the cigar wrapper) with marijuana, exposing users to both substances. The reversal in declining trends and spread to new demographic groups suggests that existing tobacco prevention programs have not adequately addressed blunt use.

The numbers in context

461,706 students; past use APC -5.32% (2010-2015); current use APC -5.28% (2010-2015) then +14.91% (2015-2018); female APC +14.92% (2016-2020); middle school APC +19.57% (2016-2020); NH white APC +11.12% (2016-2020)

How the study worked

Analysis of 2010-2020 cross-sectional, statewide representative Florida Youth Tobacco Surveys comprising 461,706 middle and high school students. Joinpoint regression calculated annual percentage change in blunt use prevalence. Multivariable regression using 2019-2020 data examined associated factors.

What this study cannot tell us

Florida data may not generalize to other states. Self-reported data in school settings may underestimate use. Cross-sectional surveys cannot track individual trajectories. Blunt definition may vary among respondents.

How to read the evidence

Large statewide representative survey with sophisticated trend analysis, though limited to one state and self-reported data.

When this study was published

Published in 2021 covering 2010-2020 survey data.

The bigger picture

The demographic shift in blunt use, with increases among girls, younger students, and white youth, suggests the behavior is diffusing beyond its historical concentration among older male and Black students, requiring broader prevention messaging.

Questions still open

  • What drove the reversal in blunt use trends after 2015? Is the increase among middle schoolers reflecting earlier initiation or just increased reporting? Should blunt-specific modules be integrated into existing tobacco prevention programs?

Common questions

What is a blunt?
A blunt is a cigar that has been hollowed out and filled with marijuana. Because the wrapper is tobacco, users are exposed to both cannabis and tobacco simultaneously.
Why did blunt use increase after 2015?
The study documented the increase but did not identify specific causes. The rise coincided with broader changes in cannabis attitudes and the proliferation of various tobacco and cannabis product types. The spread to new demographics (younger students, girls, white youth) suggests cultural shifts in who uses blunts.

Read the original research

Trends and Factors Related to Blunt Use in Middle and High School Students, 2010-2020.

Pediatrics, 148(1)

Citation

Ebrahimi Kalan, Mohammad; Jebai, Rime; Bursac, Zoran; Popova, Lucy; Gautam, Prem; Li, Wei; Alqahtani, Mohammed M; Taskin, Tanjila; Atwell, Leah L; Richards, Jennifer; Ward, Kenneth D; Behaleh, Raed; Ben Taleb, Ziyad. (2021). Trends and Factors Related to Blunt Use in Middle and High School Students, 2010-2020.. Pediatrics, 148(1). https://doi.org/10.1542/peds.2020-028159

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